A list of the most recent deficiencies for Catherine's Care Center, Inc. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | Health | 2023-05-30 | 2023-07-08 | N |
| Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Health | 2023-05-30 | 2023-07-08 | N |
| Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Health | 2023-05-30 | 2023-07-08 | N |
| Ensure each resident receives an accurate assessment. | Health | 2023-05-30 | 2023-07-08 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2023-05-30 | 2023-07-08 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2023-05-30 | 2023-07-08 | N |
| Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Health | 2023-05-30 | 2023-07-08 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2023-05-30 | 2023-07-08 | N |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2023-05-30 | 2023-07-08 | N |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2023-05-30 | 2023-07-08 | N |
| Provide appropriate treatment and care according to orders, resident?s preferences and goals. | Health | 2023-05-30 | 2023-07-08 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2023-05-30 | 2023-07-08 | N |
| Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | Health | 2023-05-30 | 2023-07-08 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2023-05-30 | 2023-07-08 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2023-05-30 | 2023-07-08 | N |
| Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | Health | 2023-05-30 | 2023-07-08 | N |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2023-05-30 | 2023-07-08 | N |
| Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Health | 2023-05-30 | 2023-07-08 | N |
| Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | Health | 2023-05-30 | 2023-07-08 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2023-05-30 | 2023-07-08 | N |
| Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Health | 2023-05-30 | 2023-07-08 | N |
| Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | Health | 2023-05-30 | 2023-07-08 | N |
| Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | Health | 2023-05-30 | 2023-07-08 | N |
| Provide and implement an infection prevention and control program. | Health | 2023-05-30 | 2023-07-08 | N |
| Implement a program that monitors antibiotic use. | Health | 2023-05-30 | 2023-07-08 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2023-05-30 | 2023-07-08 | N |
| Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Health | 2023-05-30 | 2023-07-08 | N |
| Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | Health | 2023-05-30 | 2023-07-08 | N |
| Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. | Health | 2021-05-21 | 2021-07-12 | N |
| Honor the resident's right to organize and participate in resident/family groups in the facility. | Health | 2021-05-21 | 2021-07-12 | N |
| Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | Health | 2021-05-21 | 2021-07-12 | N |
| Assure that each resident?s assessment is updated at least once every 3 months. | Health | 2021-05-21 | 2021-07-12 | N |
| Provide care and assistance to perform activities of daily living for any resident who is unable. | Health | 2021-05-21 | 2021-07-12 | N |
| Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Health | 2021-05-21 | 2021-07-12 | N |
| Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Health | 2021-05-21 | 2021-07-12 | N |
| Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Health | 2021-05-21 | 2021-07-12 | N |
| Provide enough food/fluids to maintain a resident's health. | Health | 2021-05-21 | 2021-07-12 | N |
| Provide safe and appropriate respiratory care for a resident when needed. | Health | 2021-05-21 | 2021-07-12 | N |
| Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. | Health | 2021-05-21 | 2021-07-12 | N |
| Observe each nurse aide's job performance and give regular training. | Health | 2021-05-21 | 2021-07-12 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2021-05-21 | 2021-07-12 | N |
| Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | Health | 2021-05-21 | 2021-07-12 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2021-05-21 | 2021-07-12 | N |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2021-05-21 | 2021-07-12 | N |
| Develop and implement policies and procedures for flu and pneumonia vaccinations. | Health | 2021-05-21 | 2021-07-12 | N |
| Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Health | 2021-05-21 | 2021-07-12 | N |
| Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home. | Health | 2020-02-21 | 2020-03-27 | N |
| Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Health | 2020-02-21 | 2020-03-27 | N |
| Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Health | 2020-02-21 | 2020-03-27 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2020-02-21 | 2020-03-27 | N |
| Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | Health | 2020-02-21 | 2020-03-27 | N |
| PASARR screening for Mental disorders or Intellectual Disabilities | Health | 2020-02-21 | 2020-03-27 | N |
| Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge. | Health | 2020-02-21 | 2020-03-27 | N |
| Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident?s advance directives. | Health | 2020-02-21 | 2020-03-27 | N |
| Provide appropriate foot care. | Health | 2020-02-21 | 2020-03-27 | N |
| Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | Health | 2020-02-21 | 2020-03-27 | N |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2020-02-21 | 2020-03-27 | N |
| Ensure each resident?s drug regimen must be free from unnecessary drugs. | Health | 2020-02-21 | 2020-03-27 | N |
| Provide or obtain dental services for each resident. | Health | 2020-02-21 | 2020-03-27 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2020-02-21 | 2020-03-27 | N |
| Administer the facility in a manner that enables it to use its resources effectively and efficiently. | Health | 2020-02-21 | 2020-03-27 | N |
| Provide and implement an infection prevention and control program. | Health | 2020-02-21 | 2020-03-27 | N |
| Implement a program that monitors antibiotic use. | Health | 2020-02-21 | 2020-03-27 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2020-02-05 | 2020-03-27 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2020-02-05 | 2020-03-27 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2020-02-05 | 2020-03-27 | N |
| To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Fire Safety | 2020-02-05 | 2020-03-27 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2020-02-05 | 2020-03-27 | N |
